For this week’s journal club, David, Thomas, and Audrey bring listeners short overviews of three articles. Audrey discusses an article published in the journal Pediatrics Dec 18 2017, called Exemptions from Mandatory Immunization After Legally Mandated Parental Counseling by Saad Omer, Kristen Allen, DH Chang, Beryl Guterman, Robert Bednarczyk, Alex Jordan, Alison Buttenheim, Malia Jones, Claire … Continue reading "Journal Club Lightning Round: evidence based policy and vaccine rates,...
How can we use tech to make healthcare better and more accessible? Dr. Nwando Olayiwola, a family physician, faculty member at UCSF, and Chief Clinical Transformation Officer for RubiconMD, a leading provider of electronic consultations between primary care and specialty care providers, has spent many years thinking about that question. She joins us this week … Continue reading "Nwando Olayiwola – primary care, tech, and leadership"
This week, we are joined by Dave Chokshi. Dave is the Chief Population Health Officer of OneCity Health and Senior Assistant Vice President at New York City Health + Hospitals—the largest public health care system in the U.S. He practices primary care at Bellevue Hospital and is a Clinical Associate Professor of Population Health and … Continue reading "Reprise – Population Health Management with Dave Chokshi"
This episode starts with a question: “what if the architectural design of an obstetric unit influenced the c-section rate in that unit?” That question occurred to obstetrician/gynecologist Neel Shah when he attended a presentation by Michael Murphy, the co-founder and executive director of Mass Design, an architectural design and research firm that focuses particularly on … Continue reading "Reprise – How does architectural design influence c-section rates? With Mass Design & Ariadne Labs"
Thomas Kim, David Rosenthal, and Audrey Provenzano discuss a recent article from the American Journal of Public Health called Community Health Worker Support for Disadvantaged Patients with Multiple Chronic Diseases: A Randomized Controlled Trial, by Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn Smith, and Judith Long. This important work comes from researchers associated … Continue reading "Can CHW support improve outcomes for patients with multiple chronic diseases?...
In order to make primary care better, we have to understand what is working and what isn’t – and not just in broad strokes, but in granular detail. Dr. Christine Sinsky is on the cutting edge of this type of research, and publishes prolifically on what is driving burnout in primary care, what specific steps … Continue reading "Understanding how to return joy to practice with Christine Sinsky"
Jeffrey Brenner is best known for his ground-breaking work with high-need patients in Camden, New Jersey, where he founded the Camden Coalition and changed how we all think about caring for this subset of our patients. He joins us this week and talks with us about how a shooting and subsequent relationship with the Camden … Continue reading "Caring for high need, high cost patients with Jeffrey Brenner"
How many times have you treated a dental infection in your primary care office, or spent 10 minutes after a visit googling a dentist that takes your patient’s insurance? We’ve all done it too many times. There is an epidemic of dental disease in the United States – dental care is expensive and difficult to … Continue reading "Our Oral Health Crisis with Mary Otto, author of Teeth"
David Rosenthal, Thomas Kim, and Audrey Provenzano discuss the landmark study published in Annals of Internal Medicine by Sinsky and colleagues, Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Have you ever wondered how much time you spend each month fighting with technology or filling out VNA forms? … Continue reading "Reprise – Journal Club: Sinsky et al, Allocation of Physician Time in Ambulatory Practice"
Can we solve chronic disease using a medical model? In this episode, the first in a series with speakers from the 2017 second Starfield Summit, we talked with Dr. Lloyd Michener – the principal investigator of the Practical Playbook, which facilitates the integration of primary care and public health – about why primary care clinicians need … Continue reading "Partnering Primary Care & Public Health — Lloyd Michener"
We are tremendously lucky to welcome health policy expert John McDonough as our guest this week. He has had a long and distinguished career in public service as well as a scholar and advocate. We talk about his work as a member of the MA state legislature for 13 years (discussed in his book Experiencing … Continue reading "A Career in Public Service & Drafting the ACA – John McDonough"
Today we’re joined by Lauren Taylor, a health services researcher based at Harvard Business School, where is she is earning her doctorate in health policy and management. Prior to joining HBS, Lauren co-authored The American Health Care Paradox, which has become required reading at a variety of medical and public health schools across the country. Our discussion … Continue reading "Reprise: Integration of Healthcare & Social Services with Lauren Taylor"
This week Thomas Kim, David Rosenthal, and Audrey Provenzano talk about three recently published manuscripts for a lightning round edition of Journal Club. Thomas shares a paper by Bynum et al, Outcomes in Older Adults with Multimorbidity Associated with Predominant Provider of Care Specialty, examining outcomes among patients primarily cared for by specialists vs primary … Continue reading "Journal Club: Lightning Round! Primary care vs Specialty care, Doorknob moments & Cost...
Primary care models integrating behavioral health services are being adopted across the country. This week, we talked with two leaders at the Lynn Community Health Center (LCHC), Dr. Mark Alexakos and Dr. Kiame Mahaniah, about their experience with integration. LCHC is unique among community health centers in that it started out as a mental health … Continue reading "Integrating Primary Care & Behavioral Health at Lynn CHC: Kiame Mahaniah & Mark Alexakos"
All of us like to think that we provide high-value care for our patients; but the truth is, just like the rest of the health care system, primary care provides a lot of low value care too – and we drive a lot of overuse. John Mafi joins us this week to talk about his … Continue reading "How do we improve the value of care delivered in primary care? with John Mafi"
Have you ever felt lonely and overwhelmed in a clinic room with a patient whose needs are far beyond your skills and ability to meet? I have, many times, and so has our guest this week, Dr. Lori Tishler. Dr. Tishler is the Vice President of Medical Affairs at Commonwealth Care Alliance, a not-for-profit organization … Continue reading "Lori Tishler of Commonwealth Care Alliance – Caring for the Most Vulnerable Patients"
This week, we are discussing an article from the Journal Women’s Health Issues, entitled: Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status, by Pooja Mehta, Tamala Carter, Cjloe Vinoya, Shreya Kangovi, and Sindhu Srinivas. Pooja Mehta, the lead author of the study, joins us for our conversation. You can find the … Continue reading "Understanding High Utilization of Unscheduled Care in Pregnant Women of Low Socioeconomic Status – Mehta et al"
Dr. Tom Bodenheimer is one of the world’s foremost experts in primary care re-design, having recently written about high-performing primary care clinics and the Quadruple Aim, which are articles consistently in the most-read list for the Annals of Family Medicine and among his most cited work. We focused much of our conversation on his work … Continue reading "Tom Bodenheimer – Building Blocks of High-Performing Primary Care and the Quadruple Aim"
This episode starts with a question: “what if the architectural design of an obstetric unit influenced the c-section rate in that unit?” That question occurred to obstetrician/gynecologist Neel Shah when he attended a presentation by Michael Murphy, the co-founder and executive director of Mass Design, an architectural design and research firm that focuses particularly on … Continue reading "How does architectural design impact c-section rates? Mass Design & Ariadne Labs"
Teaching health centers (THCs) are primary care residency training sites in community-based organizations, often in federally qualified health centers (FQHCs), in contrast to traditional tertiary care hospital-based training. Federal funding for the THC program, created by the ACA in 2010 and renewed through MACRA in 2015, is set to expire on September 30, 2017. THCs … Continue reading "Frederick Chen – Teaching Health Centers"